Influencer pick for surgeon general marks new era in health messaging
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Casey Means was nominated to become the new face of American public health. She's not a career doctor — but she knows how to go viral. That's the point. And the risk.
Why it matters: This is part of the Trump administration's broader strategy to prioritize messaging, allegiance and influence over expertise.
Driving the news: Means' nomination has received backlash from the medical community for not being grounded enough in scientific consensus, while also getting slammed within the Make America Healthy Again movement for not questioning vaccines stridently enough.
- Means received her medical degree from Stanford University but ultimately dropped out of her surgical residency and went on to practice functional medicine. She does not have an active medical license.
- The nutrition influencer is co-founder of the tech-based health company Levels and sister to White House senior adviser Calley Means.
Yes, but: The administration has defended Means' qualifications, claiming her critics are worried that her popularity among "MAHA moms" could create "an existential threat to the status quo interests, which profit from sickness."
- "Casey is the perfect choice for Surgeon General precisely because she left the traditional medical system — not in spite of it," Kennedy wrote on X.
State of play: The surgeon general is considered the nation's top doctor and the leading spokesperson on public health matters.
- The role has changed dramatically since its inception when the position had significant regulatory powers to issue federal public health orders, Lindsay Wiley, a professor of health law at UCLA, told NPR.
- Now, they're generally a figurehead, but those who harness the role well can usher certain pet issues into the cultural zeitgeist.
- In the 1980s, C. Everett Koop distinguished himself by taking bold public stances on smoking and AIDS.
- The most recent surgeon general, Vivek Murthy, focused on loneliness and isolation, gun violence, the mental health impact of social media, and the crisis of parental stress. His predecessor, Jerome Adams, prioritized the opioid epidemic, untreated mental illness and the links between health, economic prosperity and national security.
Between the lines: Means would be joining a federal health system that already has major communication gaps due to mass layoffs at the Department of Health and Human Services.
- Her media savvy, plus newfound position of authority, could allow her to fill this information vacuum.
The big picture: Means as surgeon general represents a continuation of the Trump administration's strategy of identifying and elevating public figures, influencers or creators who have clout within niche audiences of the MAGA-sphere.
- Trump has appointed several conservative media personalities for high-ranking government roles, including Secretary of Defense Pete Hegseth, Secretary of Transportation Sean Duffy, deputy director of the FBI Dan Bongino, and, most recently, Jeanine Pirro as interim U.S. attorney for the District of Columbia — the 23rd Trump appointee to come from Fox News.
- Aside from appointees who appeal to the Fox News audience, the administration has tapped into community passion points through micro-influencers like "MAHA moms."
- Meanwhile, the White House is filling the press briefing room with Trump-friendly media outlets and creators, while also holding regular briefings for social media influencers who will help amplify MAGA-approved messaging.
- Trump "understands television, he understands the internet, and he understands what the importance of communicating in a way that lots of traditional, trusted institutions do not understand," Claire Wardle, an expert on health communication and misinformation at Cornell University, told Axios.
What they're saying: "Means has an audience. There is no doubt on her Instagram and TikTok, she's a New York Times best-selling author," Wardle said.
- Government agencies are too often doing a bad job at communicating in a modern ecosystem, relying on press releases or interviews with traditional media organizations to relay information, she said.
- "She is reaching people in new ways that I actually would like to see more 'trusted institutions' think about," Wardle said. But while she focuses on issues many people might find important, like nutrition and obesity, she also veers into areas in which there isn't scientific consensus.
- "When you are the nation's doctor, I would argue that you really should not be saying anything unless there's scientific consensus," Wardle said.
The other side: "It would send the wrong signal to nominate a so-called social media influencer," Larry Gostin, a global health law expert at Georgetown University, told Axios.
- "Influencers often disseminate unreliable and even false health information to their audiences. We want to direct young people to authentic sources for health information, such as the CDC or credible medical organizations."
What's next: Before she becomes surgeon general, Means must first be confirmed by the Senate.
- Means' confirmation hearing before the Senate Health, Education, Labor and Pensions committee has not been scheduled.
Editor's note: This story was corrected to reflect Lindsay Wiley of UCLA made her remarks to NPR.
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